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The Notch signaling pathway is an evolutionarily conserved regulatory cascade critical in skin development and homeostasis. Mice deficient of Notch signaling molecules have impaired skin and hair follicle development associated with local tissue inflammation. However, mechanisms underlying skin inflammation and pathology resulting from defective Notch signals are not well understood. To dissect molecular and cellular mechanisms underlying development of skin immunopathology in mice defective of the Notch ligand Jagged-1 (Jag1). We assessed involvement of microbiota and immune cell subsets in skin pathogenic symptoms in Foxn1CreJag1fl/fl mice that were deficient of Jag1 in keratinocytes. We also used RNA-seq and 16S rRNA gene-seq analyses to identify molecular factors and bacterial species contributing to skin pathologic symptoms in Foxn1CreJag1fl/fl mice. Compared to Jag1-sufficient littermate control mice, Foxn1CreJag1fl/fl mice had specific expansion of IL-17a-producing T cells accompanying follicular and epidermal hyperkeratosis and cyst formation while antibody blockage of IL-17a reduced the skin pathology. RNA-sequencing and 16S rRNA gene-sequencing analyses revealed dysregulated immune responses and altered microbiota compositions in the skin of Foxn1CreJag1fl/fl mice. Antibiotic treatment completely prevented over-activation of IL-17a-producing T cells and alleviated skin pathology in Foxn1CreJag1fl/fl mice. Dysbiosis-induced over-activation of IL-17a-producing T cells is critically involved in development of skin pathology in Foxn1CreJag1fl/fl mice, establishing Foxn1CreJag1fl/fl mice as a useful model to study pathogenesis and therapeutic targets in microbiota-IL-17-mediated skin inflammatory diseases such as hidradenitis suppurativa (HS) and psoriasis. • A novel Jag1-knockout (KO) mouse model of epidermal and follicular hyperkeratosis. • Over-activation of IL-17+ T cells is responsible for skin pathology in Jag1-KO mice. • Dysbiosis causes the IL-17+ T cell over-activation in the skin of Jag1-KO mice. [ABSTRACT FROM AUTHOR]

Intracranial epidermoid tumors (ETs) are rare, benign lesions that present significant challenges in neurosurgical management due to their propensity to encase vital neurovascular structures. We aimed to evaluate the impact of clinical, demographic, and tumor-specific factors on surgical decisions (gross total resection [GTR] vs. subtotal resection [STR]) and outcomes and identify patient clusters with distinct profiles and outcomes post-resection. We retrospectively analyzed 72 patients with ET treated from 1998 to 2022, employing multivariable logistic regression for GTR versus STR predictors and Kaplan-Meier curves for progression-free survival (PFS). K-prototype clustering classified patients based on clinical data. The mean age of our cohort was 39.8 ± 20.1 years. About 13.9% of patients had a recurrence, with a median PFS of 108 months (interquartile range: 57 –206). Seizures significantly predicted GTR (P < 0.05), whereas adherence to critical structures reduced GTR likelihood (P < 0.05). Initial surgeries more often achieved GTR, correlating with longer PFS (P < 0.0001) and reduced recurrence (P < 0.01) versus re-operations. Cluster analysis identified three distinct groups, with the initial GTR cluster showing superior PFS and the lowest recurrence (P < 0.0001 and P < 0.01, respectively). Statistically significant predictors of PFS included age and preoperative seizure presence, with older age favoring longer PFS (P < 0.01) and seizures associated with reduced PFS (P < 0.01). In addition, patients with previous surgeries showed a trend toward shorter PFS (P < 0.05). This study emphasizes the importance of tailored surgical strategies in managing intracranial ETs, advocating for GTR to optimize long-term outcomes where possible. Future prospective studies are essential to further refine treatment approaches, enhancing survival for ET patients. [ABSTRACT FROM AUTHOR]

Patients commonly present to family physicians with skin findings, and distinguishing common benign skin tumors from potentially malignant tumors is important. Benign skin tumors can often be diagnosed by their history, distribution, and characteristic morphology. A biopsy or excision is indicated if there is diagnostic uncertainty or the lesion undergoes uncharacteristic or rapid change. A keratoacanthoma is a dome-shaped nodule with a central crater and can be difficult to distinguish from squamous cell carcinomas even with dermoscopy. Pilar cysts are typically benign, but rapidly growing types could have malignant qualities. Dermoid cysts, depending on their location, can have intracranial extension if untreated. Although dermatofibromas and seborrheic keratoses are benign, atypical presentations must be differentiated from melanomas. Sebaceous hyperplasia can mimic early basal cell carcinoma. Treatment options for cherry angiomas, acrochordons, slow-growing pilar cysts, and dermatofibromas should be individualized to skin type, lesion characteristics, and the patient's cosmetic preference. Generally, excision is the treatment of choice for keratoacanthomas, rapidly proliferating pilar cysts, and dermoid cysts. Cherry angiomas are treated with laser therapy and sebaceous hyperplasia with electrodesiccation. Common treatments for acrochordons and seborrheic keratoses are shave excision and cryotherapy. Pyogenic granulomas sometimes self-involute but bleed easily and often recur at the original site. They generally respond to shave excision and electrodesiccation. In patients with darker skin, treatment with cryotherapy and laser therapy should include discussions about hypopigmentation risk. [ABSTRACT FROM AUTHOR]

Gardner's syndrome has been recognized as a hereditary affliction that is autosomal in nature. This disorder is known to exhibit characteristics of familial adenomatous polyposis, of which it is also considered a variation. The features of this syndrome include the gradual development of osteomas and epidermoid cysts, including a characteristic feature that is the noted presence of intestinal polyps, which are generally multiple in number. Additionally, dental anomalies have been observed and recorded in a sizeable ratio of cases encompassing an increased frequency of multiple odontomas that are benign tumors linked to the development of a tooth and tooth agenesis/hypodontia that refers to developmental absence of one or more teeth. The other dental ascertainment includes abnormal morphology of the tooth/teeth as well as the presence of supernumerary teeth and impacted or unerupted teeth. This case report outlines the case of a 59-year-old male patient who had reported to the clinic, and was then diagnosed with Gardner's syndrome post a thorough examination. On radiographic examination, the manifestation of multiple osteomas in the frontal bone was revealed. The presence of a motley of diffused benign lesions of the bone in both the upper and lower jaw as well as the presence of an epidermoid cyst on the scalp was suggestive of an exemplar presentation of Gardner's syndrome. [ABSTRACT FROM AUTHOR]

Simple Summary: One male adult crested porcupine was found moribund in the province of Siena (Tuscany, Central Italy), and died soon after being recovered by a wildlife rescue service. At necropsy, a rounded nodule was noted on the surface of the heart. Differential diagnoses included abscess, systemic tuberculosis, parasitic cyst, and neoplasia. Histology was performed on the lesion, revealing a cystic formation in the epicardium. The cyst was lined by stratified squamous epithelium and was filled with lamellar keratin without hair shafts. The lesion was diagnosed as an epicardial epidermoid cyst (EC). EC are most commonly found in the skin, both in human and animal patients, although rarely they can occur in various internal organs. However, cardiac EC has not been reported before in animals. To the best of our knowledge, this is the first report of EC in a wild animal species. The crested porcupine (Hystrix cristata) is present in central Italy with an estimated population of 1800 individuals. Despite the local abundance, little data are available on the diseases affecting free-ranging individuals. We describe a case of an epidermoid cyst (EC) in a male adult porcupine found in the municipality of Sovicille, province of Siena (Tuscany). At necropsy, a firm rounded nodule was noted on the left ventricle wall. Histological examination revealed a cystic formation lined by stratified squamous epithelium. The cyst was filled with lamellar keratin, while hair shafts were not present. The adjacent epicardium was infiltrated by lymphoplasmacytic cells in reaction to the rupture of the cyst with the spilling of keratinaceous debris. The lesion was diagnosed as a ruptured epicardial epidermoid cyst. EC are most commonly found in the skin, both in human and animal patients, though infrequently, they can occur in any internal organ. Cardiac EC has not been reported in domestic animals, and this is the first report of EC in a wild animal species. Clinical veterinarians should consider the possibility of similar cardiac lesions in captive subjects since the long lifespan of these rodents could allow the growth of the cyst with the compression of the adjacent tissues. [ABSTRACT FROM AUTHOR]

The present study was driven by the scarcity of suitable materials for mending partial breast defects and the imperative considerations of safety and durability. The current study presents findings from two female patients, aged 59 and 40, who underwent breast cancer treatment. Patient 1 underwent a mastectomy with a sentinel lymph node biopsy, while patient 2 underwent a partial mastectomy with axillary lymph node dissection. Core needle biopsy confirmed invasive ductal carcinoma in both cases. Breast ultrasound revealed hypoechoic lesions with smooth edges. The reconstruction of the breast defect employed an acellular dermal matrix, and the safety and cosmetic outcomes for each patient were analyzed. At 3 months post-radiotherapy, neither patient experienced significant complications. The preservation of breast contour and volume was satisfactory, with no postoperative tumor recurrences detected. In summary, utilizing an acellular dermal matrix with a three-dimensional grid design for partial breast defect reconstruction offers a viable alternative that aligns with oncological safety standards and provides good cosmetic results. [ABSTRACT FROM AUTHOR]

Background Method Results Conclusion Acne vulgaris is a common inflammatory skin disease that occurs during puberty, affecting approximately 85% of young adults and may persist into adulthood. The pathophysiology of acne is multifactorial, involving hormonal, inflammatory, and immune mechanisms. Isotretinoin is widely used for treating severe cystic acne or recurrent acne. This medication is considered a pharmacological option that significantly reduces sebum secretion, leading to a reduction in the size of sebaceous glands. It also induces a lack of differentiation in sebaceous cysts, resulting in a decrease in lipid accumulation.This research is a prospective study. Patient contact details were obtained directly from those visiting the dermatology clinic, and they were monitored for a duration of 3 months. Essential data was gathered through patient examinations and inquiries at the clinic, including the prescription of tests prior to initiating isotretinoin treatment. Furthermore, follow‐up tests and examinations were performed within the initial and third months post‐treatment commencement.Sixty‐two patients participated in the study, selected through non‐probability (convenience) sampling. The therapeutic dose taken by patients was 20 mg of isotretinoin daily (n = 49) or every other day (n = 13). Among the participants, six patients experienced a decrease of 3 units or more in HDL levels, while 16 patients saw an increase of 3 units or more in LDL levels, 3 months after beginning the treatment. Additionally, the triglyceride (TG) levels increased by 9 units or more in six individuals, and the blood sugar (BS) levels increased by 5 units or more in nine individuals, 3 months after treatment initiation. Moreover, one person's waist circumference increased by 1.5 cm 3 months after treatment began. The average weight of the individuals at the end of the treatment rose from 60.74 kg to 61.12 kg. However, this weight increase was not statistically significant. (p > 0.05).In general, the results of our study show that the use of oral isotretinoin as a treatment option for the management of acne vulgaris can be effective when administered at the correct dosage, offering a safe and low‐complication option. [ABSTRACT FROM AUTHOR]

Simple Summary: Tumor-like lesions at the craniovertebral junction, including epidermoids, dermoids, and neurenteric cysts present significant treatment challenges. Our review of several cases, combined with a meta-analysis of numerous patients, aimed to identify recurrence predictors to improve treatment and follow-up accuracy. Neurenteric cysts were the most common, generally presenting with gradual symptom onset over several months and commonly located in the anterior part of the CVJ. Recurrence in neurenteric cyst cases was linked to factors such as older age, subtotal resection, complications, rim enhancement, and poor outcomes. Recognizing these predictors is essential for enhancing treatment strategies and patient management. By understanding the key factors influencing recurrence, healthcare professionals can better tailor their approaches to ensure optimal outcomes for patients with CVJ lesions. Background: Tumor-like lesions at the craniovertebral junction mimic tumors in clinical presentation and imaging. Our study focuses on three common developmental pathologies—epidermoids, dermoids and neurenteric cysts. Methods: We conducted a retrospective analysis of a case series and a meta-analysis of 170 patients from 119 reports. Results: Neurenteric cysts predominated (81.2%). Anterior cysts were linked to neurenteric cysts, while posterior ones correlated with dermoid/epidermoid cysts (p < 0.001). Complications occurred in 27.2% of cases, with cranial nerve paresis being the most common. Most patients had excellent outcomes (75.2%) with low recurrence rates (12%). Dermoid cysts were more associated with anomalies (p < 0.001). Among 138 neurenteric cyst cases, 15 experienced recurrence, with predictors including ages 51–60 and over 70, subtotal resection, complications, and poor outcomes (p < 0.001). Cysts with total resection were significantly less likely to adhere to surrounding brain tissue (p < 0.001). CSF diversion was correlated with older age (p = 0.010) and various complications (p < 0.001). Age affected outcomes, and the hydrocephalus was linked to poor outcomes (p = 0.002). Conclusions: This meta-analysis underscores the importance of total resection in minimizing recurrence rates and emphasizes meticulous preoperative planning and imaging. Our results indicate that rim enhancement (p = 0.047) and poor outcome (p = 0.007) are significant factors associated with recurrence. Additionally, associated anomalies, as well as the patient's age and overall health, significantly influence the surgical outcomes and the likelihood of recurrence. [ABSTRACT FROM AUTHOR]

The authors report three cases of epidermoid splenic cysts successfully treated by laparoscopic partial splenectomy: a 7-year-old girl, with a 4.5 cm lower pole squamous cell cyst; a 13-year-old boy, type 1 diabetic on insulin therapy, with a 7 cm upper splenic cyst of the upper spleen; and a 13-year-old girl, with a 6 cm upper epidermoid splenic cyst. All had a laparoscopic partial splenectomy. The operating times were 3h06, 4h08, and 4h05, respectively; the intraoperative blood loss was moderate, and the duration of hospitalization was 7, 7, and 12 days, respectively. No blood transfusions were required perioperatively. Only one patient suffered from persisting abdominal pain and emesis postoperatively. No recurrence occurred during follow-up. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the role of high‐resolution ultrasound (HR‐US) in the initial and differential diagnosis of the Odontogenic Cutaneous Sinus Tract (OCST) in a multicentric setting. Methods: Skin HR‐US examinations of OCSTs performed between January 2019 and June 2023 at different Institutions were retrospectively reviewed. Epidemiological and clinical data (age, gender, location of the skin lesion, causative tooth, and the clinical suspicion) as well as HR‐US imaging findings (morphology and length of the sinus tract, Doppler signal, and cortical bone interruption of maxilla or mandible) were collected. US examinations were performed by expert radiologists using a high‐performance US scanner, employing a high‐frequency linear probe (15 MHz or higher frequencies). In only one patient the HR‐US exam was integrated with strain elastography (SE). Results: Sixteen patients were enrolled with a median age of 37.6 years (range 16–70 years). The most frequent clinical suspicion was epidermal cyst, while OCST was suspected in only two cases. In all cases, HR‐US depicted the sinus tract as a nodular, triangular or "champignon‐shaped" lesion in the subcutaneous layer, which continued with a slightly tortuous band structure, up to the focally interrupted cortical bone plate. Furthermore, color Doppler evaluation showed color signals around and/or within the lesion, expression of inflammation. On SE, the sinus tract showed a hard pattern, due to fibrous and granulomatous tissue. Conclusions: HR‐US, thanks to its high spatial resolution, allows the evaluation of OCST, and play a crucial diagnostic role, mainly when the clinical suspicious is different. [ABSTRACT FROM AUTHOR]

Background: This report aims to present the case of a pediatric patient with a recurrent tumor in the superolateral orbit. Clinical Presentation: An 8-year-old patient was initially treated for a tumor in the superolateral orbit via a transconjunctival approach. The histopathological diagnosis was epidermoid cyst. Postoperatively, chronic inflammation and fistula developed in the lateral canthus area. Magnetic resonance imaging revealed a residual tumor posterior to the original tumor location. The patient was treated via a modified orbitozygomatic (mOZ) craniotomy approach that was originally applied in neurosurgery, and complete tumor removal was achieved. A temporary paralysis of the frontotemporal branch of the facial nerve was observed and fully resolved within one month following surgery. At the 18th month of follow-up, the visual, neurological, and cosmetic results were found to be satisfactory. Conclusions: mOZ craniotomy can be used to access and operate on recurrent orbital tumors in pediatric patients where other more aggressive surgical approaches should be avoided. [ABSTRACT FROM AUTHOR]

Epidermoid cyst of the spleen is a rare disease, and relatively few cases were reported by literatures. Most published case reports provided inadequate information on the impact of splenic epidermoid cyst on tumor markers. A 32-year-old woman with a giant splenic epidermoid cyst was reported, for whom the serum concentration of a collection of tumor markers (CA19-9, CEA, CA125, CA242, and CA50) increased abruptly accompanied by left upper abdominal pain for 5 days. After comprehensive preoperative examination and multidisciplinary team discussion, we ruled out any concurrent malignancy and a laparoscopic total splenectomy was performed, during which the splenic cyst spontaneously ruptured unexpectedly. After surgery, the elevated serum tumor marker levels decreased sharply until reaching normal range 3 months later. Learning from the case, we conclude that interval monitoring of serum tumor markers is of critical value for patients with splenic epidermoid cyst. Abrupt elevation of tumor marker levels and abdominal pain may serve as signs of cyst rupture, which is strongly indicative of surgical intervention as soon as possible. Total removal of the splenic cyst is strongly suggested considering the recurrence and malignant potential of the splenic epidermoid cyst. [ABSTRACT FROM AUTHOR]

AbstractNeurobrucellosis is a rare complication of brucella infection which presents as meningitis, meningoencephalitis, subdural empyema, brain abscess, myelitis, and radiculo- neuritis. We report the first case of neurobrucellosis presenting as an infected cerebellopontine cistern epidermoid cyst in a young immunocompetent male who presented with fever and acute raised intracranial pressure. MRI brain showed an extra-axial mass in the right cerebellopontine angle cistern with peripheral rim enhancement and diffusion restriction. Emergency surgery unveiled a well-encapsulated lesion containing thick pus and keratinous material, confirming an infected epidermoid cyst. Intriguingly, the culture revealed Brucella infection, but the source of the infection remained unclear. [ABSTRACT FROM AUTHOR]

Objective: This study aims to examine the clinical characteristics and surgical management of pediatric testicular epidermoid cysts, thereby contributing to the existing body of knowledge pertinent to the diagnosis and therapeutic intervention 你 s for this condition. Methods: A retrospective analysis was conducted on the clinical records of 23 pediatric patients diagnosed with testicular epidermoid cysts, who were admitted to our institution between April 2013 and February 2024. Concurrently, a comprehensive review and analysis of pertinent literature were undertaken to augment the findings. Results: The mean age at which the onset of epidermoid cysts was observed was 6.0 years. All cases were singular and unilateral. B-ultrasound diagnosis categorized 6 cases as epidermoid cysts, 11 as teratomas, and 6 as indeterminate, yielding a diagnostic sensitivity of 26.1%. All patients underwent testicle-sparing mass resection, and nine patients underwent rapid intraoperative frozen section analysis, revealing eight cases of testicular epidermoid cysts and one teratoma, with a diagnostic sensitivity of 88.89%. Postoperative histopathological examination confirmed the diagnosis of testicular epidermoid cyst. Conclusions: Pediatric testicular epidermoid cysts are an uncommon occurrence, primarily presenting as a painless scrotal mass, which can mimic the clinical features of malignant testicular tumors. Imaging modalities and histopathological assessment are pivotal in the diagnostic process for pediatric testicular epidermoid cysts. For cases where B-ultrasound is inconclusive, rapid intraoperative pathological examination should be considered. [ABSTRACT FROM AUTHOR]

Aim: To analyze the different types of benign vulvar tumors that required surgery and to correlate with the histopathological findings postoperatively. Materials and methods: This retrospective study was conducted over a period of 1 year in a tertiary care hospital in Southern India. A total of 11 benign solid vulvar masses which were operated between July 2022 and June 2023 were included in the study. Demographic data, description of the mass, time taken to seek medical attention, surgical procedure and pictographic histopathological findings were studied. Results: The study population ranges from 26 to 45 years with a mean age of 35.8 ± 7.33 years. The mean time taken to seek medical care for the detected mass was 16.25 ± 17.23 months. The earliest presentation was noted 6 months after detection, while one patient presented 6 years after the appearance of the mass. The largest mass was 12 x 15 cm in size. All the masses underwent complete surgical excision with no postoperative complications. The most common pathological finding was fibroepithelial polyp, noted in four patients, followed by leiomyoma of the vulva and vulvar hemangioma. The other masses were reported as vulvar endocervicosis, epidermoid cyst, and lipoma, respectively. It is important to note that these tumors, though benign, can cause functional, sexual, and emotional impairment. These women were followed up 6 months postoperatively and did not show any recurrence. The quality of life assessment using the VR-12 validated scale indicated the improvement in all 11 women after surgery. Conclusion: Surgical excision of benign vulvar masses not only mitigates the risk of premalignant tumors of the vulva, but also greatly improves the quality of life. Clinical significance: • This study helps us understand benign vulvar masses and the importance of surgical removal of these masses to prevent risk of malignancy. • Surgical excision helps to greatly improve the quality of life in these women. [ABSTRACT FROM AUTHOR]

Spiradenoma is a rare and adnexal skin tumor of the sweat gland appearing equally frequently in both female and male patients. When having a patient with a solitary, nodule occurring on a scalp, a spiradenoma diagnosis should be considered. However, it always ought be differentiated with more common skin lesions e.g. sebaceous cyst. This case report presents a 36 year old male presented with a solitary 1,5 centimeter in diameter mass on the scalp of the left temporal region. The patient underwent an ultrasound and excision biopsy which revealed spiradenoma diagnosis. This tumor transforms into malignant form extremely rarely. However, transformation is more likely in elderly patients having a long-standing lesions This is why early and wide excision is crucial and considered to be a gold standard treatment. Conclusion When having a patient with a solitary, nodule occurring on a scalp, a spiradenoma diagnosis should be considered. However, it always ought be differentiated with more common skin lesions e.g. sebaceous cyst. Early diagnosis and excision are gold standard when dealing with most skin lesions. A long term follow-up is required because of potential risk of malignant transformation. [ABSTRACT FROM AUTHOR]

Aim: Our aim was to investigate the frequency of various splenic cysts, to define the sonographic differential diagnostic clues and to introduce the value of twinkling artefact in the diagnosis of epidermoid splenic cysts. Material and methods: All the splenic cysts imaged by ultrasound in 3 university hospitals during the period of 2005 to 2022 were recorded, followed-up and analyzed. Results: One hundred seventy-one patients with splenic cysts were detected and these were classified and 73% of the cysts were simple. Ten cysts were epidermoid cysts as proven by post-operative final histology. Conclusion: Cystic splenic lesions are rare. Most of them are small simple cysts. Epidermoid cysts are larger in volume, constitute 6% of the total and can be differentiated by the help of twinkling artefact by Doppler ultrasound. [ABSTRACT FROM AUTHOR]

The intratarsal keratinous cyst (IKC) is a recently described entity, often clinically misdiagnosed as a chalazion. We report a case of a 61-year-old male patient with a chief complaint of a small lesion on the upper eyelid that evolved over six months. On physical examination, an asymptomatic, firm nodule was identified on the left upper eyelid. The patient reported no history of trauma. A provisional diagnosis of chalazion was established, and an excisional biopsy was performed. Histopathologically, the lesion was lined with a stratified squamous epithelium, with a corrugated epithelial surface showing abrupt keratinization without keratohyalin granules, and compact keratinous-appearing material in the cystic lumen. The diagnosis was IKC. No signs of recurrence were observed after one year of follow-up. It is essential to accurately diagnose IKC and distinguish it from chalazion and epidermal inclusion cysts, because IKC requires complete surgical excision and can exhibit multiple recurrences if not properly removed. [ABSTRACT FROM AUTHOR]

Introduction: High-frequency ultrasonography (HFUS) has emerged as a non-invasive and cost-effective diagnostic tool for evaluating the outcomes of dermatological therapeutic procedures. Aim: This manuscript presents a comprehensive collection of sonographic images depicting cutaneous lesions associated with various dermatoses, including verruca vulgaris, epidermoid cyst, maculopapular cutaneous mastocytosis and lichen sclerosus et atrophicus. Material and methods: Drawing from an extensive review of the existing literature and supported by empirical observations, the study highlights key sonographic attributes observable in both normal and pathological skin variants. Results: It has been demonstrated that individual skin lesions exhibit distinct characteristics on HFUS. Furthermore, ultrasonographic examination has proven to be valuable for the objective assessment of disease severity. Conclusions: Additionally, the study contributes to a deeper understanding of HFUS as a valuable tool in dermatological diagnostics. [ABSTRACT FROM AUTHOR]

Background: A peri‐implant cystic lesion is a rare finding, and to date most investigators have considered that its pathogenesis is caused by trauma and infection related to dental implantation. However, the pathogenesis of these cysts remains unclear and is recognized to have multifactorial origins. Case presentation: In February 2021, a 75‐year‐old male patient underwent implant restoration due to mobility of the left maxillary central incisor. The implant achieved good osseointegration and was successfully restored. However, in March 2023, the patient sought treatment due to mobility of the dental implant. Clinical examination showed that the implant had loosened in three directions (vertical, mesial‐distal, and labial‐lingual), and the peri‐implant mucosa was slightly red and swollen. Radiographic examination (cone beam computed tomography) showed a large radiolucent area with clear boundaries involving the cervical and middle portions of the dental implant, and white bone lines were observed at the edge of the low‐density shadow. Intraoperatively, we removed the patient's implant, performed a complete debridement, and conducted bone augmentation surgery in the area of bone defect. Postoperatively, the patient recovered well. The final histopathological result confirmed an epidermoid cyst. Conclusions: Peri‐implant epidermoid cyst is a rare complication that affects the long‐term outcome of implant therapy. This case serves as a warning to clinicians to avoid involving epithelial tissue in the implant site during implant surgery, in order to prevent the potential occurrence of a peri‐implant epidermoid cyst, thereby creating better conditions for the patient's recovery and the long‐term efficacy of the implant. [ABSTRACT FROM AUTHOR]

To understand the frequency and clinical presentation of the four types of vocal-fold cyst described by the Koren classification. Glottic cysts operated in a 1-year period were grouped retrospectively into Koren A, B, C and D (KA, KB, KC, KD). The age and sex of the patient, cyst location, laterality, associated lesions, profession, daily water consumption, duration of symptoms prior to surgery and postoperative healing time were noted. Of 30 cysts, 14 KA, 10 KB, 4 KC and 2 KD were identified. Average age of symptoms in KA to KD was 45, 52, 40 and 37 years. KC and KD were found only in females unlike the male predominance of KA and KB. Striking zone was the location of 28/30 cysts with a focal pit in 1 KC and mucosal bridge in 1 KD. There was no significance to laterality or profession. Average daily water consumption was 1.8, 1.75, 2 and 2 L in KA to KD. Average duration of symptoms up-till surgery for KA to KD was 2.6 years, 1.4 years, 2.9 years and 1 month. Post-operative healing time for KA to KD was 6.6, 7.4, 11.7 and 10 weeks. KA was the commonest cyst excised followed by KB, KC and KD. The KD patients were earliest and youngest to present. All KC and KD cysts were found in females unlike the male predominance of KA and KB. As majority of the cysts were found on the striking zone, phonotrauma may be one of the etiologies for all four cysts. [ABSTRACT FROM AUTHOR]

Epidermoid cysts are infrequent, benign, slow-growing, space-occupying lesions that account for 0.5–1.8% of primary intracranial tumors. We report the case of a 17-month-old child who presented in 2015 for one episode of pallor associated with hypotonia. Epilepsy was excluded and MRI was recommended. The MRI was performed and there were no focal parenchymal lesions, but it showed an extra-axial ovoid lesion with imaging characteristics consistent with epidermoid cyst. Follow-up MRI at one year was performed and it showed minimal increased in dimensions of the cyst, without changes into the signal of the lesion. Another MRI was performed 7 years after and it showed complete resolution of the cyst. Six months afterwards, another MRI was performed and it confirmed the complete regression of the cyst, without any extra-axial masses reported. The patient did not present any neurological anomalies. No follow-up MRI was recommended afterwards. Spontaneous regression of epidermoid cyst in pediatric population is an extremely rare event, but it should be taken into account when the patient shows no symptoms. This is the third case of spontaneous regression of an epidermoid cyst reported in pediatric patients, and the first one in the temporal region. Careful follow-up and watchful waiting could be an option to surgical treatment in epidermoid cysts. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This case highlights the diagnostic pitfalls that can occur when evaluating complex cystic renal masses. Distinguishing epidermoid cysts from renal cell carcinoma is difficult but imperative to guide conservative management when appropriate, avoiding unnecessary nephrectomy. Renal epidermoid cysts are extremely rare, with only 12 cases reported in the literature. Their radiographic features often resemble cystic renal cell carcinoma, frequently prompting unnecessary nephrectomy. A 64‐year‐old man with a history of nephrolithiasis presented with left flank pain and hematuria. Imaging revealed a complex cystic renal mass suspicious for renal cell carcinoma. Following left radical nephrectomy, histopathology examination revealed a benign epidermoid cyst. Renal presentation of epidermoid cyst poses unique diagnostic and therapeutic challenges. Possible pathogenesis includes ectopic epidermal implantation during embryogenesis or squamous metaplasia following chronic irritation or deficiency. Radiographic distinction from concerning entities like renal cell carcinoma is difficult but imperative to avoid extensive surgery. This case highlights the diagnostic pitfalls and management considerations for renal epidermoid cysts. Additional study of clinical and imaging factors that distinguish epidermoid cysts from renal cell carcinoma can guide conservative management when appropriate, avoiding unnecessary nephrectomy for benign disease. [ABSTRACT FROM AUTHOR]

Key Clinical Message: When treating a painless or asymptomatic mass in the submental or floor of the mouth, sublingual epidermoid cyst should be considered. Despite its irregularity, preventing malignant transformation is essential for a successful outcome. Dermoid and epidermoid cysts are rarely found in the head and neck region. They account for less than 0.01% of all oral cavity cysts. This is a rare case of a sublingual epidermoid cyst of the oral cavity in a 25‐year‐old male. The patient presented with a painless sublingual swelling for a duration of 1 month. The clinical examination revealed a non‐tender swelling in the sublingual region extending to the submental triangle. Magnetic resonance imaging confirmed a 6.2 × 7.7 × 3.2 cm cystic lesion in the sublingual space. Fine needle aspiration cytology confirmed dermoid cyst contents. Intra‐oral surgical excision under general anesthesia was performed successfully. Histopathological analysis revealed that the cyst wall was lined by stratified squamous epithelium. The presence of a prominent granular layer and keratin flakes confirmed the diagnosis of an epidermoid cyst. Postoperative recovery was good, and no recurrence was observed during follow‐up. This case emphasizes the infrequent and unusual presentation of a case of a giant plunging sublingual epidermoid cyst and promotes awareness and potential studies in the enhancement of patient care in this area. [ABSTRACT FROM AUTHOR]

Pediatric intraspinal epidermoid cysts are rare with potential to cause life-altering outcomes if not addressed. Reports to date describe symptomatic presentations including loss of bladder or bowel function and motor and sensory losses. This case report identifies the diagnostic challenge of an asymptomatic intraspinal epidermoid cyst in the cauda equina region presenting in a 7-year-old male with juvenile idiopathic arthritis (JIA). An advanced physiotherapist practitioner assessed and diagnosed a previously healthy 7-year-old-male of South Asian descent with JIA based on persistent knee joint effusions. Complicating factors delayed the investigation of abnormal functional movement patterns, spinal and hip rigidity and severe restriction of straight leg raise, all atypical for JIA. Further delaying the diagnosis was the lack of subjective complaints including no pain, no reported functional deficits, and no neurologic symptoms. A spinal MRI investigation 10-months from initial appointment identified intraspinal epidermoid cysts occupying the cauda equina region requiring urgent referral to neurosurgery. Clinical characteristics and pattern recognition are essential for diagnosing spinal conditions in pediatric populations. Diagnostic challenges present in this case included co-morbidity (JIA), a severe adverse reaction to treatment, a lack of subjective complaints and a very low prevalence of intraspinal epidermoid cysts. Early signs of pediatric asymptomatic intraspinal epidermoid cysts included abnormal functional movement patterns, rigidity of spine, severely limited straight leg raise and hip flexion without pain. Advanced physiotherapist practitioners can be integral to pediatric rheumatology teams considering their basic knowledge in musculoskeletal examination and functional mobility assessment when identifying rare spinal conditions that present within the complex context of rheumatic diseases. [ABSTRACT FROM AUTHOR]

Wandering spleen is extremely uncommon, with a reported incidence of <0.5%. A cyst within the spleen is also uncommon. The majority of primary splenic cysts fall into the epithelial cyst category. The affected patients present with atypical symptoms, like feeling fullness in the left upper abdomen and a palpable mass. The treatment of a large wandering splenic cyst is an open splenectomy. This case presents a unique combination of a wandering spleen with a huge ruptured cyst, featuring an unusual right lower abdominal and pelvic location, a twisted pedicle, and a remnant of normal splenic parenchyma, collectively constituting an exceedingly rare clinical scenario. [ABSTRACT FROM AUTHOR]

This case study critically examines the long-term detrimental effects of female genital mutilation (FGM), specifically focusing on the development of clitoral epidermoid inclusion cysts. The study illuminates the oftenoverlooked post-mutilation complications that extend beyond immediate physical trauma, encompassing significant anatomical alterations with potential psychosocial implications. As a direct consequence of FGM, clitoral epidermoid inclusion cysts represent a physical manifestation of such prolonged complications, contributing to discomfort, potential sexual dysfunction, and an overall decline in quality of life. In an unusual case, a 38-year-old African woman presented with a painful clitoral tumor intermittently draining for three years. The study underscores the urgent need for comprehensive preventive measures, early diagnosis, and effective management strategies in affected populations to mitigate the enduring consequences of this harmful practice. : [ABSTRACT FROM AUTHOR]

Epidermoid cysts are prevalent noncancerous cutaneous lesions known to exhibit unusually extended periods of growth. In this study, we present a remarkable case of an epidermoid cyst located on the scalp, which exhibited a growth period of 76 years, the longest growth time documented in the literature to date. The presence of the mass was noted at birth, and it exhibited gradual growth throughout the years, with a notable acceleration observed during the final 2 years. The patient underwent a surgical excision, and the histopathological analysis was consistent with epidermoid cyst, featuring localized rupture and demonstrating foreign body granulomatous inflammation. This case highlights the ability of epidermoid cysts to manifest as slow-growing entities over an exceptionally prolonged timeframe. Furthermore, instances of rapid growth may be attributed to a combination of mass rupture and inflammatory processes. [ABSTRACT FROM AUTHOR]

Epidermoid cysts are ectodermally derived benign extra-axial lesions that have typical imaging characteristics following cerebrospinal fluid (CSF) signal intensity, but occasionally show unusual hyperintensity on T1-weighted images (T1WI), known as white epidermoid, thus posing a diagnostic challenge. We report an unusual case of bilobed prepontine white epidermoid masquerading as tuberculous abscess in a known case of tubercular meningitis. [ABSTRACT FROM AUTHOR]

A 68-year-old man with a history of remote sinus surgery presented with several months of progressive diplopia, proptosis, and epiphora. He was found to have a large, cystic mass in the lateral extraconal space of the right orbit, which was removed. Pathology demonstrated an epidermoid cyst with recurrence at post-operative month 3. Follow-up resection was performed with the insertion of a modified Jones tube into the maxillary sinus to serve as a persistent outlet and prevent future recurrence. At post-operative month 18 after tube insertion, he remains without disease recurrence. The authors describe this novel technique as a method to prevent recurrence in orbital cyst management. [ABSTRACT FROM AUTHOR]

This article discusses a case study of an adult male who presented with a swelling in the right cervical region since childhood. The swelling was diagnosed as an epidermal inclusion cyst based on fine needle aspiration cytology. The cyst was excised and histopathology confirmed the diagnosis. The article provides information about the diagnosis, location, and treatment of bronchogenic cysts, which are rare congenital malformations that typically occur in the pediatric age group. The article emphasizes the importance of considering bronchogenic cysts as a differential diagnosis for neck masses in adults. [Extracted from the article]

The author wished to detail the life and contributions of Dr. Adelola Adeloye, MBBS, MS, FWCS, FRCS, FACS, FRCP, in hope to pay homage to this giant in Global Neurosurgery. Dr. Adelola Adeloye was born on July 18, 1935 in Illesa, Osun State, present-day South-West Nigeria. The Adeloye-Odeku disease is an eponym for a congenital dermoid or epidermoid inclusion cyst (CDIC/CEDIC) over the anterior fontanelle and below the galea aponeurotica. In 1971, Adeloye and Odeku first described these cysts in 18 Nigerian patients. While overall rare and predominantly noted in children, the Adeloye-Odeku disease has been found to impact adults too. In terms of rarity, CDICs make up 0.1–0.5% of cranial tumors and 0.2% of inclusion cysts. CDICs can be distinguished from CEDICs through histopathology as dermoid cysts may contain hair follicles, sweat, sebaceous glands, and teeth, whereas CEDICs usually are only composed of keratinized debris and epidermal tissue. Assumed first to be an African cyst, cases of the Adeloye-Odeku disease were subsequently reported in other ethnic populations: Turkish, Czechs, Slovaks, Chinese, Japanese, Canadians, Saudi Arabians, Indians, Caucasians, Bangladeshis, Spaniards, and Brazilians. [ABSTRACT FROM AUTHOR]

Intracranial epidermoid cysts are rare, benign tumors. Nevertheless, the microsurgical removal of these cysts is challenging. This is due to their capacity to adhere to the neurovascular tissue, as well as the associated difficulties in microsurgically peeling off their capsular wall hidden in dead angles. To better understand the rate of recurrence after surgical intervention, we have performed preoperative and postoperative volumetric analysis of epidermoid cysts, allowing the estimation of their growth rate after resection. Imaging data from 22 patients diagnosed and surgically treated for an intracranial epidermoid cyst between 2000 and 2022 were retrospectively collected from 2 European neurosurgical centers with microsurgical expertise. Volumetric analysis was performed on magnetic resonance imaging data. Average cyst volume at diagnosis, before any surgery, measured in 12 patients was 28,877.6 ± 10,250.4 mm3 (standard error of the mean [SEM]). Estimated growth rate of incompletely resected epidermoids after surgery was 1,630.05 mm3 ± 729.95 (SEM). Assuming linear growth dynamics and normalizing to postoperative residual volume, the average postoperative growth rate corresponded to 61.5% ± 34.3% (SEM) of the postoperative residual volume per year. We observed signs of recurrence during a radiologic follow-up period of 6.0 ± 2.8 years (standard deviation) in more than 50% of our patients. Due to their slow-growing nature, epidermoid cysts can often reach a complex multicompartmental size before resection, even in young patients, thus requiring complex approaches with challenging capsular resection, which implies a high risk of nerve and vascular injury per se. Tumor recurrence may be predicted on the basis of postoperative volumetry. [ABSTRACT FROM AUTHOR]

Background/Aim: Breast cancer is a complex disease with variability in clinical manifestation, response to current therapy, and biochemical and histological features among various subgroups. Histologic grading and immunohistochemical evaluation of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 proliferation index play a crucial role in increasing the differential diagnostic value among various types of breast carcinoma. The aim of this study was to determine the histopathological and immunohistochemical characteristics of breast tumors from a University Laboratory of Pathology in Greece. Patients and Methods: The study included female patients over 18 years of age, whose histopathological and immunohistochemical reports were stored in the archives of the First Department of Pathology of National and Kapodistrian University of Athens. The study involved 197 female patients with a median age of 70 years and median tumor size of 2.6 cm. Results: Most tumors were located at the left breast and ductal carcinoma was the most common histologic type (35.5%). Most tumors had histologic grade 2 (106, 53.8%), and were classified as TNM stage IIA (65, 33%). Most grade 1 and 2 tumors exhibited high expression of PR, whereas most grade 3 tumors had no PR expression. Moreover, patients with triple-negative cancer presented with grades 2 and 3 at a lower percentage compared to patients without a triplenegative phenotype (p=0.001). Conclusion: The study provided valuable insights into the histopathological and immunohistochemical characteristics involved in the development and progression of breast cancer. [ABSTRACT FROM AUTHOR]

It is extremely uncommon to develop primary intracranial squamous cell carcinoma, which is typically brought on by the malignant transformation of epidermoid cysts or, less frequently, by other non-malignant epithelial cysts. We report a case of squamous cell carcinoma arise in the supra sellar region. She was operated via pterional approach. The patient was plaint of decrease in visual acuity. 6 months follow-up showed visual improvement. Intracranial squamous cell carcinoma is a rare disease whose clinical presentation, treatment, and prognosis are still unclear. [ABSTRACT FROM AUTHOR]

Epidermoid cysts (EC) are lesions developing from neuroectodermal epithelial cells. They represent 1–2% of all intracranial tumors and are usually found in cerebellopontine angle and parasellar regions. To the best of our knowledge, only 27 cases have been reported of EC in sellar and suprasellar region. In 12 cases out of the 27, surgery was done by craniotomy means. The 7 most recent manuscripts (with 15 patients described) share in common the use of endoscopic endonasal approach (EEA) to perform surgical removal. In this paper, we report the safe removal of epidermoid cysts arising from the pituitary using an EEA in two patients, which should be the sixth such description in literature. In both cases, resection and evolution was favourable. Surgical resection is the treatment standard for epidermoid cysts, with total resection including the cyst wall to prevent recurrence when possible. The degree of resection obtained is limited by adherence to nearby neural and vascular structures. The advent of EEA approaches has allowed safe maximal resection especially in midline lesions nearby sellar and suprasellar compartiments. [ABSTRACT FROM AUTHOR]

Background: Many cutaneous lesions are clinically suspected as "cyst"; however, following histopathological examination, are found to be more significant lesions. Here, we examine the frequency and features of malignancies with cutaneous cysts in the clinical differential. Methods: A retrospective study of surgical pathology specimens at the James A. Haley Veterans' Hospital from January 2018 to December 2022 was conducted. Cutaneous specimens containing the clinical diagnosis of "cyst" were included. The clinicopathological features were summarized. Results: Premalignant or malignant neoplasms accounted for 4.5% of all specimens submitted with cysts in the clinical differential. Most cyst‐mimicking cancers were basal cell carcinoma (BCC) or squamous cell carcinoma (SCC); however, cancers with poorer prognoses, such as Merkel cell carcinoma and melanoma, also clinically masqueraded as cysts. The BCCs were predominately nodular, and the SCCs were largely well‐differentiated and invasive. Many exhibited clinical signs and symptoms compatible with benign cysts, such as central punctum, pain, and rapid growth. Identified risk factors included history of prior non‐melanoma skin cancer diagnosis, previous excision, and immunosuppression. Conclusions: Many lesions clinically concerning cutaneous cysts were found to be malignancies following histopathological review. Accordingly, following biopsy all cyst‐like lesions should be examined microscopically, especially in certain clinical contexts in which the incidence of skin cancer is increased. [ABSTRACT FROM AUTHOR]

Primary cutaneous mucinous carcinoma (PCMC) is a rare malignancy of the sweat glands that most commonly affects the periorbital area. It is characterized by slow growth over a prolonged period, and its morphology can be easily confused with a benign tumor, such as an epidermal cyst. Consequently, many patients experience recurrence after undergoing multiple resections. However, there are few reports concerning the surgical management of PCMC. We present two cases of PCMC originating in the periorbital area. The first case involved a 76-year-old man with a mass measuring 3.0× 1.5 cm that had been increasing in size. The second case was a 61-year-old man with two masses, each measuring 1.0× 1.0 cm, that were also growing. Both patients underwent wide excision with a 5-mm safety margin, which was determined based on the widest view of the cross-section of the mass on the magnetic resonance imaging. Subsequently, based on the intraoperative frozen biopsy results, both patients underwent additional excision with a 5-mm safety margin in only one direction. This report shows that, when determining the surgical margin of PCMC in periorbital area, employing imaging modalities and intraoperative frozen biopsies can be helpful for narrowing the surgical margin. [ABSTRACT FROM AUTHOR]

Anal cystic lesions are extremely rare. From October 2011 to August 2023, 3 (0.12%) of the 2498 anal surgery cases performed in our hospital had cystic lesions. They were 38, 56, and 69 years old, all male, and cystic lesions were located anterior to the anus. The cysts were elastic and soft, and the preoperative diagnosis was thrombosed external hemorrhoids or cysts, but histopathologic examination revealed epidermal cysts in two cases and teratoma in one case. Teratomas in the anus show similar histological features to tailgut cysts and retrorectal cyst-hamartomas, and are thought to be rare cysts caused by the remnants of cloaca. They are usually located in the retrorectal space; cases located in the perianal region are extremely rare, and only four cases including ours have been reported in Japan. We present each case and report a case of teratoma in the anal region with a review of the literature. [ABSTRACT FROM AUTHOR]

Key clinical message: An epidermoid cyst is a benign tumor in many locations. The symptoms of an epidermoid cyst depend on its location. The brain or spine MRI can confirm the lesion. Removing total decompression is the first choice in treatment with a symptomatic cyst. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Sebaceous cysts are a prevalent form of benign cutaneous cysts that often manifest as epidermal cysts when their size exceeds 5 cm in diameter. Despite their infrequent occurrence, cases of massive epidermal cysts measuring 5 cm or larger have been documented. Malignant transformations within epidermal cysts are exceedingly rare but not impossible. Although their development into malignancies is a rare event, it is essential to acknowledge the potential for benign epidermal cysts to undergo such transformation. In clinical terminology, these cysts predominantly affect the facial, cervical, and dorsal regions. They usually remain asymptomatic, with their formation attributed to the sequestration of epithelial remnants during embryonic fusion or trauma. In this report, we present a remarkable case of a colossal epidermal cyst found on the upper back of a 75‐year‐old male individual, highlighting the uncommon nature of such occurrences within the medical domain. This case adds to the literature by presenting a rare case report highlighting the clinical presentation, probable consequences, and surgical therapy of larger epidermal cysts. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Testicular epidermoid cysts have characteristic findings. Testicular tumor markers are negative in patients with epidermoid cysts. Clear margins and sole and small testicular tumors (20 mm or less) suggest the possibility of epidermoid cyst. Testicular‐sparing surgery with intraoperative frozen section examination should be performed when suspecting epidermoid cysts. Testicular epidermoid cysts are rare tumors that account for 1% of all testicular tumors and are often clinically misdiagnosed as malignant lesions. We report three cases of epidermoid cysts. The chief manifestations were scrotal induration in two patients and pruritus scrotum in one. The median age of the patients was 23 years (18–30). All tumors were determined to be sole lesions (<20 mm in diameter). Testing for tumor markers in all patients revealed negative results. We could not rule out malignancy; hence, we performed high inguinal orchiectomy in all cases. Histologically, the inner walls of the cysts were lined with stratified squamous epithelium; their contents were keratinized. All patients were diagnosed with epidermoid cysts. [ABSTRACT FROM AUTHOR]

Merkel cell carcinoma (MCC) is an extremely rare and aggressive tumor. Here we report an unusual MCC that manifested as an abruptly enlarging, painful skin lesion over the right antecubital fossa and masqueraded as an epidermal cyst in a 42-year-old male. The lesion was surgically excised and subjected to histopathologic and immunohistochemical examinations. The subsequent analysis allowed for the diagnosis of MCC. Clinicians should always be cognizant of MCC, which can be easily misdiagnosed. Early diagnosis and appropriate treatment are keys to improving the survival rates of MCC patients. [ABSTRACT FROM AUTHOR]

Dermatofibrosarcoma protuberans (DFSP) is a slow-growing, soft-tissue tumour of early or mid-adult life, affecting both the genders equally. The most common sites are soft tissue of the trunk (50 to 60%), followed by proximal extremities (20 to 30%) and the head and neck region (10 to 15%). Its metastatic potential is low though the local recurrence rate is high. Here, we report a case of a female patient with a large soft tissue growth located at the right cheek, chin and neck region. Local excision was done under the impression of a benign tumour such as lipoma or sebaceous cyst. Histological evaluation showed bland spindle cells arranged in a storiform pattern questioning the provisional diagnosis of the lesion. Further evaluation with the immunohistochemistry (IHC) panel confirmed the diagnosis of DFSP. Since it is a rare tumour of the head and neck region with non-alarming initial presentation and the potential for erroneous diagnosis as another lesion, we present a case of DFSP. [ABSTRACT FROM AUTHOR]

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Background: The umbilicus is a fibrous remnant located in the centre of the abdomen. Various entities may be encountered in this special anatomical location; however, little is known about their dermoscopic presentation. The aim of this study was to provide a comprehensive summary of existing evidence on dermoscopic features of umbilical lesions. Methods: Studies assessing dermoscopic images of umbilical lesions were included in this study. No age, ethnicity or skin phototype restrictions were applied. Papers assessing lesions outside of the umbilical area, lacking dermoscopic images and/or dermoscopic description and not related to the topic were excluded. Embase, Medline and Cochrane Library were searched from inception to the end of May 2023. The Joanna Briggs Institute critical appraisal tools were used to evaluate the risk of bias of the selected studies. The quality and the level of evidence of included studies were assessed according to the Oxford 2011 Levels of Evidence. Thirty-four studies reporting a total of 39 lesions met the inclusion criteria and were included in qualitative analysis. Results: A qualitative synthesis of the following entities was performed: melanoma, nevi, basal cell carcinoma, fibroepithelioma of Pinkus, Sister Mary Joseph nodule, mycosis fungoides, dermatofibroma, endometriosis, epidermal cyst, granuloma, intravascular papillary endothelial hyperplasia, lichen planus, omphalolith, seborrheic keratosis, and syringoma. Conclusions: Dermoscopy is a non-invasive technique that may be useful in the differential diagnosis of umbilical lesions. The main limitations of this study were lack of a high level of evidence in the studies and the lack of uniformity in applied dermoscopic terminology between included studies. [ABSTRACT FROM AUTHOR]

Introduction: Pilomatrixomas are benign neoplasms derived from hair follicle matrix cells. They are among the most common soft tissue head and neck tumors of childhood. Pilomatrixomas are typically isolated, slow-growing, firm, nontender masses that are adherent to the epidermis but mobile in the subcutaneous plane. This clinical presentation is so characteristic that many experienced surgeons will excise suspected pilomatrixomas without prior imaging. We reviewed the results of this approach to determine whether physical examination alone differentiates pilomatrixomas from other similar soft tissue lesions of the pediatric head and neck. Methods: Computerized review of all pilomatrixomas over a 20-year period in a single academic pediatric otolaryngology practice. Results: 18 patients presented to our pediatric otolaryngology practice between 2001 and 2021 with historical and physical findings consistent with pilomatrixoma. Of the 18 patients, 7 were male and 11 were female. Ages ranged from 1.5 to 14 years, with a mean of 7.5 years. Most of the lesions (12) were located in the head and face, while the rest (6) were found in the neck. All patients were treated with complete surgical excision. Pathology confirmed pilomatrixoma in 15 patients. The remaining 3 children were found to have an epidermal inclusion cyst, a ruptured trichilemmal cyst, and a giant molluscum contagiosum lesion, respectively. One additional patient presented with a small lesion of the auricular helix that was thought to be a dermoid cyst, but proved to be a pilomatrixoma on histologic examination. Discussion: As pilomatrixomas are common and have a very characteristic presentation, surgical excision without prior diagnostic imaging will lead to correct treatment in the majority of cases. High resolution ultrasonography can help to confirm the diagnosis preoperatively, but is not definitive in large case series. Most of the cystic lesions that imitate pilomatrixoma will ultimately require surgical excision. [ABSTRACT FROM AUTHOR]

Testicular mixed germ cell tumor is common in the post-pubertal age, less so in prepuberty. There are only 3 reports of prepubertal mixed teratoma and yolk sac tumor. Two of these cases had immature teratoma component and were in the neonatal age group. The third case in a toddler had a mature teratoma component. An 18-month-old boy presented with a testicular mass. Serum AFP was elevated (2200 ng/ml). The orchidectomy specimen contained a yolk-sac tumor and a small epidermoid cyst, indicating a mature teratomatous component. We report a testicular mixed teratoma and yolk sac tumor, prepubertal type along with summary of prior published cases. There is only one report describing this combination of mature teratoma with yolk sac tumor in the prepubertal testis. [ABSTRACT FROM AUTHOR]